Practicing Preps-Wounds

[Mother]

No doctor or medical facility is availabe to you. One of your family members has sustained a deep wound made by a hand saw.

 

How would you handle this wound if no artery has been severed but in ordinary circumstances it would require stitches?

 

How would you handle it if the wounds is more serious and an artery has been nicked or severed?

 

How would you handle smaller wounds and punctures?

 

[Screaming Eagle]

Mom,

Now that's a good well-defined scenario to think through a number of principles.

The main priniciple to consider in wound care is really very basic. Details follow from the main principles. The principle for any kind of wound trauma is:

 

Stop the bleeding

Dress the wound

Treat for shock

 

Worst first for me is a basic triage way of thinking (I'm an RN by profession). Stopping an arterial bleed is much more difficult than a veinous wound. Arteries are larger and deeper than veins and there is more pressure because the arteries are flowing 'from' the heart to extremities while veins take blood from extremities back to the heart. Arteries are deeper within our flesh because we have a great God that created us to survive (thank you Lord).

Pressure is probably the first thing I'd do. If there is clothing that can be ripped to form an initial bandage I'd use it. As a way of thinking, I'd try to have someone else deal with it rather than the individual who is hurt. Shock is very quick and emotionally overwhelming almost instantly when we observe serious wounds. Having someone else take care of it, speaking words of assurance (even if it's 'made up') and doing what is necessary to calm that individual. Pressure, some sort of makeshift tourniquet, elevating the limb, calming the individual (including providing warmth with them lying down), encouraging slow deep breathing etc would the initial steps I'd take. Their need at the moment is to know that someone's in charge that knows what they're doing so fake it as best you can regardless of the situation. Prayer is always a good thing. More serious wound care would follow from that once the bleeding is at least minimized.

Non-arterial cuts are still dangerous and can still result in shock even though they're (at least theoretically) not as near life-threatening as an arterial bleed. Arterial blood has a rich bright red color that is distinctly different from veinous de-oxygenated blood. Most of us see de-oxygenated blood from normal cuts since they're generally shallower cuts. The exception might be cuts along the 'sides' of fingers which is where blood vessels flow in your fingers. Pads of fingers don't have larger blood vessels so they bleed slower. Cuts along 'sides' of fingers up and down the fingers are where the larger vessels are.

The principle would be the same for treatment. Stop the bleeding, dress the wound, treat for shock. Shock in and of itself is worth taking a close look at since it's such an integral part of any number of scenarios and can result in a life-threatening situation. It's also very individual as some people seem to be more prone to going into shock regardless of their physical makeup.

Puncture wounds have the possibility of introducing bacteria deep into blood flows so they can be deceptively dangerous. Even if there is little overt, clear bleeding on the surface there will, in all likelihood, be deeper bleeding which will lead to swelling and closing off of surface tissue. You probably want a puncture wound to drain (depending of course on how bad it is) to help wash itself out. Hydrogen Peroxide would be good on puncture wounds (soak if possible) because it kills anaerobic bacteria that don't need air to multiply. It's not the best initial choice for surface wounds because it actually delays some of the early wound healing processes, but in this case it would be a good initial choice if possible.

Again, you probably want a puncture wound (especially a deep puncture) to drain at least for awhile. The tendency is for it to close on the surface (normal coagulation and clotting is at work) but that can lead to sealing bacteria in the wound and increase swelling. Elevating the limb is always good and really does help decrease swelling. Makes sense mechanically if you think about it.

I'm kinda in a hurry right now so I'll come back for some of the others you've posted. Let me know if you want more specific direction from these principles. I'd much rather teach the principles than bog you down with details at this point in t he discussion.

[Vic303]

1. for heavy bleeds, arterial or otherwise, I have a stock of Israeli bandages and Celox. First is pressure & elevation (pressure from the Israeli bandage if necessary, otherwise gauze pads and direct pressure by hand. If bleeding fails to stop, then it's time to break out the Celox. Rebandage after that with pressure.

 

2. I am not in a position to suture, nor do I wish to trap bacteria in the wound so I am most likely to clean the wound and use some povidone iodine and h.peroxide, then apply topical antibiotic ointment and bandage. Regular dressing changes and reapplication of antibiotics.

 

3. Minor wounds are cleaned & bandaged with antibiotic ointment, and monitored.

 

4. Punctures are encouraged to bleed, cleaned & treated with the iodine & peroxide, antibiotic ointment, and either lightly bandaged or left open to monitor more easily.

[Mother]

Great replies both. We could use a larger list of supplies necessary to handle these situations. Details would be good too as some people may wish to print these out for future references.

 

Please do not hesitate to add your posts even if they might be repeats of what is here. Sometimes just reading it again makes it more understandable.

 

((( )))

[Spider]

With my recent cut, it had to be cauterized to stop the bleeding. Think back to movies and books from pioneer times. Are we ready to cauterize something if it needed to be?

[Screaming Eagle]

Another use for a hot glue gun? ;-)

[CrabGrassAcres]

Grab the first aid kit. Slap on a tourniquet. Flush the wound with sterile saline. Ease off the tourniquet and identify bleeders. Tighten tourniquet if heavy bleeding and use hemostat to grasp bleeder and tie off with suture. Flush again and check for bleeders. If no further bleeders take off tourniquet and blot wound with sterile guaze. Check to see if any tendons are cut. If there is no possibility of a doc, I'd try to sew the tendons back together then flush with betadine followed by sterile saline and suture the wound. Apply heavy sterile dressing. Administer antibiotics from stash. If tendons had to be repaired I would splint the limb to give it the best chance of healing.

[Spider]

Have some kind of "pain killer" to help, because the nerves are going to be screaming.

[CrabGrassAcres]

All I have for pain killers is Tylenol and Aspirin and Motrin. It is really hard to legally get your hands on anything else these days so I'm kinda out of luck there.

[Jeepers]

Originally Posted By: CrabGrassAcres

All I have for pain killers is Tylenol and Aspirin and Motrin. It is really hard to legally get your hands on anything else these days so I'm kinda out of luck there.

Same here. I do have a couple of very old Tylenol with codine though. I bought a bottle of vodka for my preps. I could mix it with orange juice, Seven Up or cola. I rarely if ever have a drink so a couple of shots of that would probably knock me out. At the very least I wouldn't be feeling a lot of pain for a while. Maybe not the best solution but if I was in that much pain I'd probably do what ever it takes to get relief.

[Mt_Rider]

Puncture wound: I can speak to care of danged horses who are rather prone to this sort of wound. Ya just pray that the puncturing item imbeds so that the wound goes upwards....meaning that the hole is at the bottom so it can drain with the horse standing. Cuz horses aren't that cooperative or flexible to elevate the legs....LOL. lol I have a syringe (without the needle) in our horse kit, which I use in this case. I get a diluted iodine mix [ SE -- would you dilute the H.Peroxide for the puncture or straight up?] and use the squirty thing to force the solution as deep into the wound as possible. I do repeated flushing and hopefully soon after the wound occured. As SE mentioned, the mouth of the wound will tend to swell and close up quickly. Horses are sometimes quite stoic as one crawls beneath one at minus 8 degrees on the snow with flashlight - cuz of COURSE it's dark.... At least you can usually move human patients indoors. lol In the case of animals, you would want them in the best shelter you have, at least windbreak. And a horse blanket would be good cuz they do shock too.

 

We've broken open the wound for the next several days to make sure it can still drain. Oral antibiotics are real handy in the case of puncture wounds. Especially if the puncture is in a downward direction and therefore cannot drain by gravity. If no vet was there and the pocket area of a downward puncture was swelling up with puss, you might have to make a small cut to open that area and clean it out.

 

MtRider [have played 'vet' on many occasions]

 

[Mt_Rider]

Other wounds: I made one of the purchases that I've wanted on hand - a field wound care kit. Has hemostats, scapel, sutures (& bought more and should buy more), etc. Am also buying strong cotton thread. This [please, God!] is not really for my use. DH is a chiro and has all the anatomy/physiology, etc to handle sutures.

 

BUT this is when we set our jaw and look a problem square in the face. I am truly phobic of needles (set off by receiving the long series of rabies shots in stomach when I was 7 ). I go into shock just LOOKING at them, for Pete's sake! I have a long and quite embarrassing history of VERY NEARLY passing out when even my dog gets a shot or a kid in my care (not mine) got stitches. SO - would I choose to try to close a wound if it was DH (& *that's* a likely scenario!) that needed it? Of COURSE I would try but how?

 

HOW NOT TO PASS OUT - when the caregiver gets shocky......

First that comes to mind is to set myself into ultra-clinical mode. QUICKLY. Before my "stuff" gets any chance to start. I'd be telling myself "SELF! Are you listening Self? Cuz you GOTTA do this so focus on what you have to do right now!" I'd also be PRAYING cuz "Self" has never listened very well when we have had these conversations. It is simply in a realm where my logic does not work so well. It also occurs to me that I would grab an ice pack (bag of snow, break-open ice pack, or wet soppy cloth) and have it handy as I began the suturing step. This is for ME...to fight the blacking out if it would come on me before I'd finished what had to be done. I break out in sweats...maybe soak the top of my head with water? I might be digging my knee into the floor (or similar act) to cause myself a pain to focus on. I would remember to breathe! If I had to, I would lower my head to the floor and clear it, and then come back up and continue. [this HAS worked for me but it slows down what you are trying to accomplish considerably] Mind you, blood does this to some people. For me it's only those sneaky, nasty needles....

 

 

 

Before stitching, obviously handling the blood flow comes first if it's excessive. And the flushing, cleaning. I'm good with a sewing needle to repair shredded/torn jeans. I'd be guessing but I'd do it similar to that. If it's deep and needs something stitched deep inside or otherwise repaired....I'm outta my league there.

 

 

 

Just some thots as I try to figure out how to work around my 'other' disability. NEEDLES!

 

 

OH, and don't forget to sterilize the equipment. Alcohol soak or boil 'em????

 

 

Other equipment: I keep all old T-shirts, etc and cut them into roller bandages or squares. The hems are kept to tie off other bandages. I keep old towels for sopping up a mess. I keep ....everything cuz sooner or later, the nice store-bought stuff is gonna be gone. It would be nice to (hot boil) sterilize some of this and seal them into plastic. I don't have a sealer so I'd try to use the store sterile ones and use the clean but not sterile ones for outter layers.

 

 

MtRider

 

[Mt_Rider]

Oh, I forgot. We grow yarrow up here. Lots of it all over. That's a blood stopping herb...tho I've never had the need to try it out yet.

 

 

MtRider [ also looking up my copied pages of yarrow]

[westbrook]

just another good reason to store Vodka! it is after all not only a disinfectant but a pain killer too!

[Mother]

 

I was a wild life rehabilitator for many years. In our state this is all strictly volunteer and no funds are available for the animals care, it all comes out of our pockets. While the local vets were wonderful about donating their services, all meds were out of pocket expense and I learned very quickly to utilize what Mother Nature gives us. These are some of my observations with not only the wildlife but also the domestic animals and people in my own family and a few others as well.

 

This is one area that herbal medicine shines. Herbs can go a long way towards disinfecting and healing the wound topically and many are used orally as an immune booster to help your own body fight against infection.

 

It’s already been suggested how to assess the wound and to stop bleeding. Under primitive conditions that might be difficult. A tourniquet, stitching, or cauterizing might be your only options if an artery or severe bleeding is involved. In less severe wounds often sugar, generously layered on the wound, will stop bleeding and help disinfect also. Honey has been bringing rave reviews as a healer but old time doctors and herbal practitioners have known this for ages. Honey is also antiseptic. Cayenne sprinkled on the wound or as a tincture used on it will often stop bleeding but be aware it burns to begin with when applied. It usually does numb the area eventually though.

 

Lacking modern medicines or disinfectants, clean the wound as thoroughly as possible with soap and water, soaking the wound if possible as long as there is no chance of starting bleeding again. A wash of thyme tea is antiseptic also. Thymol or the oil of thyme was used during WW1 in the field surgeries very effectively. Echinacea (heals and helps rebuild damaged tissue as well as helping with the pain), calendula (soothing, anti-inflammatory, antiseptic, astringent to inhibit bleeding, and healing), St. John's Wort (Healing), Balm of Gilead (Popular tree that is and used for pain), Chamomile (used with slowly healing wounds), (to name just a few that could be used) can then be used as a compress. A moist compress speeds healing, whereas using an herbal ointment could slow the healing of a large wound. Ointments could be used after the initial healing when you want to soften the area to leave as little scar as possible. An ointment or salve could be used for small scratches, cuts or abrasions.

 

Use sterile gauze if possible and use purified water to make the infusion or to carry the tincture. Use one tablespoon of dried herb or four of fresh in one cup of almost boiling water for the infusion and steep it at least ten minutes, covered, if using a leafy herb. The same amount of root or bark herb would be simmered in the water for at least twenty minutes. Strain well. I use coffee or milk filters or several layers of gauze. Dip sterile gauze or at least a very clean piece of material into the hot liquid, cool to comfortable temperature and lay on the wound as a compress, changing it frequently. If using a tincture only a few drops in a cup of water need be used for a compress.

 

If the wounds is infected you can use a compress of plantain which draws out the infection. This would need to be kept warm to work well. This also works well for puncture wounds, abcesses, and boils. Plantain is also antimicrobial and anti-inflammatory and though it does contain allantoin (see comfrey below) it’s action is primarily drawing and healing.

 

To soothe a wound or abrasions use mallow or slippery elm.

 

Comfrey is a well-known herbal healer but I would not suggest that you use it on wounds that have any possibility to become infected. Comfrey contains allantoin, a cell proliferent, and could heal the outside of the wound faster than the inside, allowing infection to grow. Comfrey is a super herb for using as a compress on unbroken skin, such as over a broken bone. In fact, one of its common names is Knit Bone. It will help remove a bruise as well. Comfrey salve is good for abrasions and small clean cuts.

 

Willow bark, the forerunner to aspirin, can be used as a tea for pain but be aware that it can, potentially, thin the blood and cause more bleeding. Meadowsweet can be used in place of or along with willow bark. Yarrow is great as anti-inflammatory and will also add a pain inhibiting measure. Adding lemon balm, valerian root, or chamomile to the tea can be calming and soothing.

 

There are many more herbs that can be used for wounds but these are at least a start. Most can be grown in your garden or yard and some are found growing wild.

 

As far as closing a wound, I’ve done my fair share of stitching and believe me, it’s not a fun occupation for either the stitcher or the stiched if you have no way of numbing the area. (Diluted clove oil or clove tea applied to the wound will help but burns a bit to begin with before it takes hold) If the wound was not deep I would most likely use a butterfly bandage to close it or just leave it if it is in a place that will heal readily or the scar would cause no problems later. If the wound was deep and/or stitches were required to stop bleeding I would not hesitate to attempt the closure. I stockpile various suture material and though it’s from many years ago it is manufactured sealed yet and would most likely be usable yet.

 

And as Westy so aptly points out, Vodka, in fact many different spirits, can be an indispensible part of a med kit and not for just the reasons she gives but also for making herbal tinctures.

 

((( )))

[TXQFMom]

very good to read this! Thanks!

 

I have not yet had to deal with a wound this severe yet in a human.... but my anti-dr dh is working on giving me plenty of practice. {{shake head}} Not to mention dc...

 

My new favorite things in my arsenal are

vet 7% stronger iodine (now next to impossible to get due to meth)

golden seal powder

tea tree oil (works great for the dc & I, but dh is allergic)

vet wrap! coflex bandage... whatever you want to call it.. this stuff is incredible for covering wounds first with sterile dressing then vet wrap. Comes in lovely colors too.. when my dh buys it he always gets PURPLE!

 

Yep alchohol can be helpful.... dealt with an ugly situation with dh around Christmas... 1st time with nothing... 2nd cleaning & changing someone had given him some *leaded* egg nog... and that helped lots.

 

I have stitched up a goat that was ripped open and I think I am learning I can do what I *have to* at the time.

 

I do think handling all we can NOW is good prep.

[Mother]

TXQFMom. It's great to see your posts. I'm sure you are going to fit right in here.

 

You are welcome for the info. I agree, handling all we can now and getting used to doing it, living our preps, will help us adjust when the time comes.

 

Good luck with the new birth. I'm looking forward to reading your posts.

 

[westbrook]

another use for Vodka... take a swig or two before having to stitch up the patient! if you patient has had enough to drink ... they won't even notice!

 

stitching....can I get it under the presser foot of my sewing machine? pass that vodka please!

[The MacKinnon]

Hi there TXQF Mom!

 

I'm a San Antonio native myself. You are right about the Vetwrap stuff. A long while back, when I was at Texas A&I, one of the school horses crawled up in the hay loft (don't ask, but I do have a photo and when we unpack I'll post it) and when I got to him to guide him out, his eyeball was hanging out.

 

We got the vetwrap and stuck his eyeball back in the socket til the vet could get there. The eye was saved and Helita (the horse) never missed a munch.

 

So the vetwrap is a great addition to your 1st aid kit. Actually there are several barn items that would be good additions, including leg wraps, and some compresses.

 

 

[TXQFMom]

Oh my I'd love to see the pic... well not so much the eye falling out... but then I tend to take pics of injuries... yes I am odd.

[MamaTiger]

I appreciate the info here in this thread. I try now to use my herbal remedies for most things that come up rather than OTC or the doc/script route. But it's wonderful to read the info here as I can always learn something new.